Outcome of palliative self-expanding metal stent placement in malignant colorectal obstruction according to stent type and manufacturer

Surg Endosc. 2011 Apr;25(4):1293-9. doi: 10.1007/s00464-010-1366-6. Epub 2010 Oct 26.

Abstract

Background: Self-expandable metallic stents (SEMS) of varying designs and materials have been developed to reduce complications, but few comparative data are available with regard to the type of stent and the stent manufacturer. We analyzed the success rates and complication rates, according to stent type (uncovered vs. covered stent) and individual stent manufacturer, in malignant colorectal obstruction.

Methods: From November 2001 to August 2008, 103 patients were retrospectively included in this study: four types of uncovered stents in 73 patients and two types of covered stents in 30 patients. The SEMS was inserted into the obstructive site by using the through-the-scope method.

Results: Technical and clinical success rates were not different between stent type or among stent manufacturers: 100 and 100% (p = ns) and 100 and 96.6% (p > 0.05), respectively, in uncovered and covered stents. Stent occlusion and migration rates were 12.3 and 3.3% (p = 0.274) and 13.7 and 16.7% (p = 0.761), respectively, in uncovered and covered stents, and 11.1, 5, and 9% (p = 0.761) and 25.9, 15, and 0% (p = 0.037) in Wallstent, Niti-S, and Bonastent uncovered stents, respectively.

Conclusions: The placement of SEMS is an effective and safe treatment for patients with malignant colorectal obstruction. Although minor differences in outcome were detected according to the type and the manufacturer of the stents, no statistically significant difference was observed, except in stent migration among the stent manufacturer.

Publication types

  • Comparative Study

MeSH terms

  • Adenocarcinoma / complications*
  • Adenocarcinoma / secondary
  • Aged
  • Aged, 80 and over
  • Alloys
  • Carcinoma / complications
  • Carcinoma / secondary
  • Chromium Alloys
  • Coated Materials, Biocompatible
  • Cobalt
  • Colonic Diseases / etiology
  • Colonic Diseases / surgery*
  • Colonic Neoplasms / complications*
  • Colonic Neoplasms / secondary
  • Colonoscopy
  • Equipment Design
  • Female
  • Fluoroscopy
  • Foreign-Body Migration / epidemiology
  • Foreign-Body Migration / etiology
  • Humans
  • Intestinal Obstruction / etiology
  • Intestinal Obstruction / surgery*
  • Male
  • Middle Aged
  • Palliative Care*
  • Pancreatic Neoplasms / pathology
  • Radiography, Interventional
  • Rectal Diseases / etiology
  • Rectal Diseases / surgery*
  • Stents* / classification
  • Stomach Neoplasms / pathology
  • Treatment Outcome
  • Uterine Cervical Neoplasms / pathology

Substances

  • Alloys
  • Chromium Alloys
  • Coated Materials, Biocompatible
  • phynox
  • nitinol
  • Cobalt